Overview
Long-sightedness affects the ability to see nearby objects. You may be able to see distant objects clearly, but closer objects are usually out of focus.
It affects people of all ages – including babies and children but the effects of it often progressively worsen as people get older.
The medical name for long-sightedness is hyperopia or hypermetropia.
It is important to note that it is different from presbyopia (age related blur) which affects the ability to see objects close up due to ageing changes in the eye. Presbyopia effects people that are long-sighted, short-sighted and people that have astigmatism, and results in people needing different glasses for different tasks or bifocals or varifocals (both special lenses that have different powers within the same lens)
Symptoms of long-sightedness
Long-sightedness can affect people in different ways.
Most people start by only having trouble focusing on nearby objects, but as people get older they may struggle to see clearly at any distance.
If you are long-sighted you may:
- find that nearby objects appear fuzzy and out of focus, but distant objects are clear
- have to squint to see clearly
- have tired or strained eyes after activities that involve focusing on nearby objects, such as reading, writing or computer work
- experience headaches
- experience blurred vision in the distance after focusing on things up close for a long time
Children who are long-sighted often do not have obvious issues with their vision at first. But if left untreated, it can lead to problems such as a squint or lazy eye.
Getting an eye test
If you think you or your child may be long-sighted, you should book an eye test at an optometrists/opticians.
Having an eye test at least every 2 years is usually recommended, but you can have a test at any point if you have concerns about your vision.
An eye test can confirm whether you're long- or short-sighted, and you can be given a prescription for glasses or contact lenses to correct your vision.
For some people, including children up to 19 in full time education and those over 60, eye tests are available free of charge on the NHS. There are also certain income related benefits which not only entitle you to a free eye test but may mean you qualify for free or NHS subsidised glasses. Find out more about free NHS eye tests to check if you qualify.
Find a local optician
Causes of long-sightedness
Long-sightedness is when the eye does not focus light on the retina (the light-sensitive layer at the back of the eye) properly.
This may be because:
- the eyeball is too short
- the cornea (transparent layer at the front of the eye) is too flat
It's often not clear what causes these problems, but they're rarely a sign of any underlying condition.
Sometimes long-sightedness may be a result of the genes you inherited from your parents.
Treatments for long-sightedness
Children and young adults with long-sightedness may not need any treatment, as their eyes are often able to adapt to the problem and their vision may not be significantly affected.
Treatment is usually required in older adults, particularly those over 40, as your eyes become less able to adapt as you get older.
There are several ways long-sightedness can be corrected.
The main treatments are:
- prescription glasses – these have lenses that are made specifically for you which ensure light is focused onto the back of your eyes correctly
- contact lenses – some people prefer these to glasses because they are lightweight and virtually invisible
- laser eye surgery – a laser is used to change the shape of the cornea, which may mean you don't need to wear glasses or contact lenses
Glasses are the simplest and safest treatment. Contact lenses and laser eye surgery carry a small risk of complications and are not usually suitable for young children.
Read more about how long-sightedness is treated.
Diagnosis
You can find out if you have long-sightedness by having an eye test at an opticians and as stated above this may be free on the NHS.
What happens during an eye test
Your eyes will usually be tested by an optometris/opticiant (someone who's been specially trained to examine the eyes).
The optometrist will begin by asking you why you have come for an appointment and any issues you may be having, they will also ask you some questions about your lifestyle and your job so they can work out what your visual needs are. They will ask some questions about your general health, any medication you may be taking, any past eye problems and some family history questions.
The actual tests that an optician carries out may vary and can depend on your age and your answers to some of the above questions but will likely include the following.
- Checking what you can see in the long distance and close up by reading some letters
- Putting lenses in front of your eyes in a frame or a machine in front of your eyes to see if they improve what you can see
- Several eye health checks which may include photos of your eyes
- Machines that check your peripheral vision and an air puff test (not always done for younger adults and even more rarely for children) to check the pressure inside the eyeball (to check for glaucoma[HH(1] and other conditions)
This will help the optometrist find the right glasses prescription for you and check that your vision problems aren’t caused by an eye health problem.
Understanding your glasses prescription
If an eye test finds that you're long-sighted, you'll be given a prescription for lenses to improve your vision. This can be used for glasses and/or contact lenses.
Your prescription will usually consist of 3 main numbers for each eye. These are:
- Sph (sphere) – a positive number here indicates that you're long-sighted, while a negative number indicates that you're short-sighted[HH(2]
- Cyl (cylinder) – this number indicates whether you have astigmatism[HH(3] (where the front of your eye is not perfectly curved)
- Axis – this describes the angle of any astigmatism you have
If you're long-sighted, the Sph number is the most relevant. This is given in a measurement called dioptres (D), which describes how severely long-sighted you are.
A score up to 3D is usually considered to be mild long-sightedness, while a score of more than 6D is considered to be moderately high long-sightedness.
Treatment
There are several ways that long-sightedness can be corrected.
Glasses
Long-sightedness can usually be corrected simply and safely by wearing glasses with lenses that have been prescribed specifically for you.
Wearing lenses that have been prescribed specifically for you will ensure that light is focused onto the back of your eye (retina) correctly, so that close objects do not appear as blurry.
The thickness and weight of the lenses you need will depend on how long-sighted you are. You can buy thinner lenses which improve this but they are more expensive. Long-sightedness can get worse with age, so the strength of your prescription may need to be increased as you get older.
Some people are eligible for help with the cost of glasses frames and lenses, for example, if you are under 19 and in full time education or if you are receiving certain income related benefits
If you're not eligible, you'll have to pay for your glasses. The cost can vary significantly, depending on your choice of frame.
Contact lenses
Contact lenses can also be used to correct vision in the same way as glasses. Some people prefer contact lenses because they are lightweight and almost invisible, but some people find them more of a hassle than wearing glasses.
Some contact lenses can be worn once then discarded at the end of the day (daily disposables), while others can be disinfected and reused.
Your optician can advise you on the most suitable type of contact lenses for you. If you decide to wear contact lenses, it is very important that you maintain good lens hygiene to prevent eye infections. It is normally advised that you have a pair of glasses as well as contact lenses so you can take regular breaks from contact lens wear and in case there is a reason you can’t use your contact lenses, or you run out of your regular supply.
As with glasses, some people are entitled to vouchers towards the cost of contact lenses
If you're not eligible, you'll have to pay for your contact lenses. The cost can vary, depending on your prescription and the type of lens you choose.
Laser eye surgery
Laser eye surgery involves using a laser to reshape your cornea (the transparent layer at the front of the eye) to improve the curvature so light is better focused onto the back of your eye.
The most commonly used type of laser eye surgery for long-sightedness is called laser in situ keratectomy (LASIK).
Before the procedure starts, local anaesthetic drops are used to numb the eyes. During the procedure, a thin protective layer is created in the front of the cornea with one type of laser, then the cornea is reshaped by another type of laser.
It takes around 30 minutes and both eyes are normally treated on the same day. You can go home soon afterwards and are usually able to return to work and driving the following day.
LASIK can only be done if your cornea is thick enough, the curvature of the cornea is not too steep, and the surface of your eye is in good health. Techniques using artificial lens implants (see below) are more suitable for some people, particularly older people.
Find more information about laser surgery from The Royal College of Ophthalmologists.
Results
LASIK can improve both reading and distance vision, allowing you to socialise and do outdoor activities without wearing glasses or contact lenses.
Most people who have laser surgery report that they're happy with the results, but glasses may still be necessary for some activities after treatment.
Also, as with any type of surgery, the results of laser surgery cannot be guaranteed and there's a risk of complications. Sometimes the treatment may need to be repeated.
Risks and complications
Laser eye surgery has some risks and side effects.
- eye discomfort – laser eye surgery can temporarily affect the protective layer of tears over the front of the eye. Many people have some eye discomfort in the early period after treatment. Lubricant eye drops can help, but are not usually required for more than a few months.
- hazy vision – it takes around 3 to 6 months to fully recover from LASIK, and many people notice blur or haze around bright lights in the early weeks. About 1 in 20 people needs further laser treatment to improve their vision.
- there's also a small risk of potentially serious complications that could threaten your vision, such as the cornea becoming infected or scarred. But these problems are rare and can be treated with corneal transplantation if they do happen.
Make sure you understand all the risks involved before deciding to have laser eye surgery.
Who cannot have laser surgery?
You should not have laser eye surgery if you are under the age of 21. This is because your vision may still be developing.
Even if you're over 21, laser eye surgery should only be done if your glasses or contact lens prescriptions has not changed significantly over the past 2 years or more.
Laser surgery is also not suitable if you:
- are pregnant or breastfeeding – your body will contain hormones that cause slight fluctuations in your eyesight, making precise surgery difficult
- have other problems with your eyes, such as dry eyes or cataracts (cloudy patches in the lens of the eye)
Laser eye surgery can generally be effective for long-sighted people with a prescription of up to 4D (see understanding your prescription), although some people with higher prescriptions can be treated effectively. Your eye surgeon can advise you about this.
Availability and cost
Laser surgery is not usually available on the NHS because other treatments, such as glasses or contact lenses, allow you to see well enough to do most normal activities. You'll usually have to pay for surgery privately.
Prices can vary depending on the type of prescription you need, where you live, the individual clinic and the type of equipment used during the procedure. But as a guide, you usually have to pay around £600 to £2,500 for each eye.
Artificial lens implants
Laser eye surgery is not suitable for people with the early stages of cataracts, which is more common as you get older. It also does not usually result in complete freedom from glasses for older people.
Surgery to replace the natural lens inside the eye with a multifocal lens implant is now often used as an alternative to laser eye surgery for the correction of long-sightedness.
This operation, called refractive lens exchange, is similar to cataract surgery. It's performed under local anaesthetic and you can go home soon afterwards. As with laser eye surgery it is not guaranteed that you will have complete freedom from glasses, especially for reading.